Clinical efficacy and safety of posterior minimally invasive surgery in cervical spondylosis: a systematic review

Background Posterior minimally invasive surgery has been increasingly used in in recent years for the clinical treatment of cervical spondylosis. However, this treatment remains challenging and has not been comprehensively reported. The aim of this study was to provide a systematic review of posteri...

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Published in:Journal of orthopaedic surgery and research 2022-08, Vol.17 (1), p.1-389, Article 389
Main Authors: Lv, Junqiao, Mei, Jun, Feng, Xiaoning, Tian, Xuefeng, Sun, Lin
Format: Article
Language:English
Subjects:
Bias
Bone surgery
Central nervous system diseases
Cervical spondylosis
Channel
Complications
Decompression
Drug therapy
Endoscopy
Health surveys
Keyhole
Kyphosis
Laparoscopy
Medical research
Medicine, Experimental
Minimally invasive surgery
Orthopedics
Patients
Percutaneous endoscopy
Posterior minimally invasive surgery
Postoperative
Questionnaires
Safety
Spinal cord
Spinal osteophytosis
Spine (cervical)
Spondylosis
Statistical analysis
Surgery
Surveys
Systematic Review
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Summary:Background Posterior minimally invasive surgery has been increasingly used in in recent years for the clinical treatment of cervical spondylosis. However, this treatment remains challenging and has not been comprehensively reported. The aim of this study was to provide a systematic review of posterior minimally invasive treatment for cervical spondylosis to demonstrate the clinical efficacy and safety of this procedure. Method We collected information from patients with myelopathy or radiculopathy cervical spondylosis who underwent posterior minimally invasive surgery and verified the clinical efficacy and safety of these surgeries with different measurement indicators from five electronic databases: the Nurick, visual analog scale score, Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI), EuroQol Five Dimensions Questionnaire (EQ-5D) score, Short-Form Health Survey Physical Component Summary (SF12-PCS) questionnaire score, Short-Form Health Survey Mental Component Summary (SF12-MCS) questionnaire score, and the MOS item short form health survey (HF-36) score. The decompression effect, cervical spine stability, average surgery time, surgical blood loss volume, length of hospital stay, and related complications were included in the descriptive analysis. Reporting of this protocol followed the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines checklist. Results We identified 14 observational studies of cervical spondylosis with 479 patients, mainly including 197 cases of myelopathy and 207 cases of radiculopathy. Channel and endoscopic techniques were used. This study was certified by PROSPERO: CRD42021290074. Significant improvements in the quantitative indicators (Neck-VAS in 9 studies, JOA in 7 studies, NDIs in 5 studies, Nurick, ARM-VAS, and EQ-5D in 2 studies each, and the SF12-PCS, SF12-MCS, and HF-36 in 1 study each) were observed between pre- and postoperation (P < 0.05), and satisfactory clinical significance was acquired in the descriptive indicators [average surgery time (94.56 [+ or -] 37.26 min), blood loss volume (68.78 [+ or -] 103.31 ml), average length of stay (2.39 [+ or -] 1.20 d), and cervical spine stability after surgery]. Additionally, we showed that there was a 4.9% postoperative complication rate and the types of complications that may occur. Conclusion Posterior minimally invasive surgery is an effective and safe method for the treatment of cervical spondylosis and is a recommended o
ISSN:1749-799X
1749-799X
DOI:10.1186/s13018-022-03274-3